Individual
JOEL BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3107 N 50TH ST, TAMPA, FL 33619-2302
(813) 367-2317
(813) 367-2312
Mailing address
4612 N 56TH ST, TAMPA, FL 33610-7123
(813) 367-2317
(813) 367-2312
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH9474
FL
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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